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"I found out I had HIV when I was pregnant for the first time, in 2009. In Kyrgyzstan, all women are tested during pregnancy twice, once early on and once later in the pregnancy. They say it is your choice whether to get tested, but if you don't then you cannot get maternity services. The result was a shock but I wanted to have my child.

My medical card has a code on it which shows that I have HIV to anyone who knows the codes... as soon as people in the hospital saw that code, they didn't want to help me

I sat down with my own maternity doctor and with the AIDS Centre and made a plan with them about the delivery and how it would be managed, because there is a lot of stigma associated with HIV in Kyrgyzstan. So, my doctor understood the issues. But when I started to give birth, my doctor was not available. So that meant I had to go to the maternity hospital and be seen by whoever was there. My medical card has a code on it which shows that I have HIV to anyone who knows the codes. There was no question about whether I disclosed my status – it was already there, on my medical card. And as soon as people in the hospital saw that code, they didn't want to help me. They started to find all kinds of reasons for rejecting me, for not being able to help with the delivery, but it was only because they were afraid of my HIV. Even the management of the hospital didn't want to accept me.

When people came to help with the birth, they were dressed up with gloves and suits and masks like spacemen

Eventually, I managed to contact the Head of the AIDS Centre and they intervened with the Head of the hospital to let me stay there, because I was about to give birth. But even then and despite their intervention, I was put in an isolation room. When people came to help with the birth, they were dressed up with gloves and suits and masks like spacemen. They were obviously very reluctant to touch me or even the baby. They left us in isolation the whole time I was there recovering, even when the baby was crying. It was awful. Afterwards I went back to that hospital with people from the AIDS Centre. We did some training with them and I talked about my experience and why it was wrong. It was very successful and it has led to further training sessions in other maternity hospitals, so I hope that some good has come of it. But I know, from later experiences and from other women, that there is still a long way to go to get rid of stigma in our maternity system.

They left us in isolation the whole time I was there recovering, even when the baby was crying. It was awful

"

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HCV, HBV viral control improves kidney transplant survival rates

14/03/2019

Kidney transplant recipients with hepatitis B and hepatitis C in whom viral replication was controlled had similar overall and graft survival rates as patients without viral hepatitis, according to data published in Journal of Hepatology.

Fontaine and colleagues compared the overall and graft survival rates of kidney transplant recipients with either HBV or HCV and 29,798 patients without viral hepatitis. Virological data showed that 157 patients with HBV from 167 available records had controlled viral replication. HCV RNA was undetectable in 155 of 441 patients with HCV virological data.

Ten-year overall survival in patients with HCV (71.3%) was significantly lower than those with HBV (81.2%; P = .0004) and patients without viral hepatitis (82.7%; P < .0001). Similarly, 10-year graft survival was significantly lower in those with HCV(50.6%) than those with HBV (62.3%; P < .0001) and those without viral hepatitis (64.7%; P < .0001).

“Future studies are needed to confirm what has been previously reported in high-risk population for HCV (intravenous drugs user and men who have sex with men), namely whether systematic antiviral treatment can decrease or even eliminate the incidence of viral hepatitis in dialysis patients and [kidney transplant recipients].”

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